Despite interest in reducing psychosocial distress in family caregivers of individuals with dementia, few controlled trials have been conducted to establish the efficacy of specific treatment strategies. In addition, there is a need for interventions available to rural caregivers who do not have access to the same types of services provided in large metropolitan communities. The proposed project would study 120 emotionally distressed female caregivers, ages 50 and older, who have a husband or parent diagnosed with probable Alzheimer's disease or a related dementia. Following a psychosocial evaluation at Time One, caregivers would be randomly assigned to one of two treatment conditions: a 10-week psycho-educational intervention using videotaped material and telephone contact with a mental health professional (VT); or community-based treatment as usual (CT). At the conclusion of the VT intervention, or after about three months for participants in the CT condition, the Time 2 evaluation would occur to measure the extent of improvement in the indices of psychological distress. All participants will be reevaluated again after six months (Time 3). The video and telephone intervention uses cognitive and behavioral techniques to reduce depression and upset following patient behavior problems; the intervention has already been developed and has received support from preliminary studies. The purpose of the current project is to revise the intervention to increase its efficacy, and extend the sample to rural caregivers. The major hypotheses of the study are: caregivers who participate in the video and telephone intervention will show greater improvement in psychological distress compared to those in the Community Treatment as Usual condition, with greater treatment effects for rural compared to suburban and urban dwelling caregivers, and one of the mechanisms for reduced depression in VT participants will be increased self-efficacy for controlling upsetting thoughts about care giving.